Contentment still possible for Alzheimer's patients

'Validation therapy' appears to help

July 17, 2000
Web posted at: 5:43 p.m. EDT (2143 GMT)

From staff reports

(CNN) -- From World Alzheimer's Congress 2000 reports to the Clinton administration's pledge of $50 million in increased funding for research, encouraging news about future treatments for Alzheimer's disease has multiplied in recent days.

But as work continues toward a reliable vaccine and more effective drugs, some Alzheimer's specialists advocate a simple method known as "validation therapy" to ease the stress Alzheimer's can create for those who have the disease and for their caretakers. Validation therapy calls for a basic caregiver attitude adjustment, according to therapist Naomi Feil.

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Forcing the Alzheimer's-afflicted to "face reality" can often be counterproductive, Feil said, explaining that when patients become confused, they tend to turn inward and lose their desire to communicate. The idea behind validation therapy is to just let them talk, and to act as if what they are saying is perfectly fine, even when they appear to be living in another time or place, or are confused about who is who.

"The old person who is confused (then) knows you respect them. They have intuitive knowledge," she said. "They may have lost clock time, they may have lost speech, they don't know who you are, but they put you right in their world."

Eleanor Shutter has tried things both ways with her mother, Margaret, diagnosed with Alzheimer's in 1997.

"We were discussing something and I just thought I had to make her understand where I was coming from, and she couldn't," remembers Shutter. "And the more I would talk to her, the more agitated she would get, the more agitated I got ... and it ended up she would sit there and not speak to me."

Now, Shutter is more likely to go with the flow.

"I think she is a happier person now," she said. "She becomes less upset, and I think it gives me a good feeling too."

There is a theory that as people age, "they need to express unfinished issues," said Feil. "And the more deteriorated they are, the more incontinent they become emotionally."

Shutter said her mother is more talkative and outgoing now than when she tried so hard to keep her mother in the present.

There is no evidence that using validation therapy will improve patients' memories or cognitive abilities, but it does seem to increase their enjoyment of life.

This therapy is just one of several avenues of current research, many of which were reported during the World Alzheimer's Congress 2000. The worldwide gathering of scientists and Alzheimer's advocates ends Tuesday in Washington.

"The most visible breakthroughs have been in research," actor David Hyde Pierce, whose father and grandfather had Alzheimer's, told CNN Monday. "But more importantly, or as important, which isn't getting as much coverage, are the breakthroughs in people coming together from all over the world to discuss better ways of taking care of people now, until we find a cure, and that's vital."

Hyde Pierce, of "Frasier" fame, is a member of the national board of directors of the Alzheimer's Association.

"One of the reasons we need so much funding is that clinical (drug) trials take five years each, and we need to be able to run multiple trials at the same time," he said. "Otherwise, by the time we do get to find a cure, it will be too late in terms of the huge numbers of people that will be coming down with the disease as our population ages.

Alzheimer's experts said Monday they expect a critical shortage in careworkers over the next decades, as millions of baby boomers age and are diagnosed with the disease.

About 12 million people, including 4 million in the United States, have Alzheimer's, according to the latest estimates. The debilitating brain disease influences the lives of millions of other people, particularly family members of patients.

People with Alzheimer's develop plaques and tangles in the brain, which eventually kill nerve cells, causing dementia and other problems. Researchers believe it happens when certain chemicals attack brain cell proteins. Brain tissue also becomes inflamed.

Several drug compounds are currently being tested for effectiveness against memory loss. Work progresses on a vaccine. And researchers are studying the role played by environmental factors such as a high-fat diet and high cholesterol and blood pressure.

CNN Medical Correspondent Holly Firfer contributed to this report.

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